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Effects of genetic variants on platelet reactivity and one-year clinical outcomes after percutaneous coronary intervention: A prospective multicentre registry study.

 Hyung Joon Joo  ;  Sung Gyun Ahn  ;  Jae Hyoung Park  ;  Ji Young Park  ;  Soon Jun Hong  ;  Seok-Yeon Kim  ;  WoongGil Choi  ;  HyeonCheol Gwon  ;  Young-Hyo Lim  ;  Weon Kim  ;  Woong Chol Kang  ;  Yun-Hyeong Cho  ;  Yong Hoon Kim  ;  JungHan Yoon  ;  WonYong Shin  ;  Myeong-Ki Hong  ;  Scot Garg  ;  Yangsoo Jang  ;  Do-Sun Lim 
 SCIENTIFIC REPORTS, Vol.8(1) : 1229, 2018 
Journal Title
Issue Date
Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR. Death, myocardial infarction (MI), stroke, stent thrombosis, and bleeding events were assessed during a 1-year follow-up period. Primary endpoints were death and non-fatal MI. The cumulative 1-year incidence of death and stent thrombosis was significantly higher in patients with CYP2C19*2/*2, CYP2C19*2/*3, and CYP2C19*3/*3 (Group 3) than in patients with CYP2C19*1/*1 (Group 1). Multivariate Cox proportional hazard model showed that cardiac death risk was significantly higher in Group 3 than in Group 1 (hazard ratio 2.69, 95% confidence interval 1.154-6.263, p = 0.022). No association was reported between bleeding and OPR. Thus, CYP2C19 may exert a significant impact on the prognosis of PCI patients even in the era of newer-generation drug-eluting stents.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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